活血明目汤联合雷珠单抗治疗非缺血型视网膜分支静脉阻塞继发黄斑水肿的临床研究  

Clinical Observation of Huoxue Mingmu Decoction Combined with Ranibizumab on Macular Edema Secondary to Non-ischemic Branch Retinal Vein Occlusion

作　　者：杜红彦 王蓉 李建良 骆煌 简月玲 蔡金英 Du Hongyan;Wang Rong;Li Jianliang;Luo Huang;Jian Yueling;Cai Jinying(The Affiliated Traditional Chinese Medicine Hospital of Guangzhou Medical University,Guungdong,Guungzhon 510130,China)

机构地区：[1]广州医科大学附属中医医院,广东广州510130

出　　处：《中国中医急症》2020年第8期1381-1383,1399,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81704123);广东省中医药局科研项目(20182109)。

摘　　要：目的评价活血明目汤联合雷珠单抗治疗非缺血型视网膜分支静脉阻塞(BRVO)继发黄斑水肿的临床疗效并探讨其作用机制。方法70例患者随机分成治疗组与对照组各35例。两组均给予玻璃体腔内注射雷珠单抗,每月1次,连续治疗3次。治疗组在此基础上服用活血明目汤,每天1次,1个月为1个疗程,共观察3个疗程。观察两组治疗前后的最佳矫正视力、视网膜中心凹厚度及视网膜中心凹容积变化。结果治疗后1个月、3个月,治疗组总有效率分别为82.86%、91.43%,均高于对照组的60.00%、82.86%(均P<0.05)。两组治疗2周后最佳矫正视力均提高,治疗组最佳矫正视力与治疗前比较差别改善(P<0.01),对照组则与治疗前比较差别不大(P>0.05),治疗组最佳矫正视力优于对照组(P<0.05)。两组治疗后1个月及治疗3个月最佳矫正视力均较本组治疗前改善(均P<0.01),且治疗组视力改善幅度均大于对照组(P<0.05或P<0.01)。两组治疗后2周CMT均下降,治疗组CMT与治疗前比较改善(P<0.01),对照组则与治疗前比较差别不大(P>0.05),治疗组CMT优于对照组(P<0.05)。两组治疗后1个月及3个月CMT与本组治疗前比较均下降(P<0.05或P<0.01),治疗组降低幅度均大于对照组(P<0.05或P<0.01)。两组治疗后2周、1个月及3个月CMV与治疗前比较均下降(均P<0.01),且治疗组降低幅度均大于对照组(P<0.05或P<0.01)。结论活血明目汤联合雷珠单抗治疗BRVO可提高患者视力水平,改善继发性黄斑水肿,临床疗效优于单用雷珠单抗。Objective:To evaluate the clinical effect of Huoxue Mingmu Decoction combined with ranibizumab on macular edema secondary to non-ischemic branch retinal vein occlusion(BRVO)and explore its mechanism of action.Methods:70 patients were randomly divided into the treatment group and the control group,35 cases in each.Two groups were given intravitreal injection of ranibizumab,once a month.The treatment group took Huoxue Mingmu Decoction,once a day on that basis,a month as a treatment course,with three courses of observation of the two groups.The best corrected visual acuity,central macular thickness and central macular volume were observed before and after treatment.Results:1 month,3 months after treatment,the total effective rate of the treatment group was 82.86%and 91.43%respectively,which were higher than that of the control group(60.00%and82.86%)(P<0.05).After 2 weeks of treatment,BCVA was improved in both groups,BCVA in treatment group was improved compared with that before treatment(P<0.01),there was no statistically significant difference between the control group and before treatment(P>0.05),the treatment group was better than the control group(P<0.05).After 1 month and 3 months of treatment,BCVA of the two groups improved compared with that before treatment(P<0.01),the improvement of vision in the treatment group was greater than that in the control group(P<0.05 or P<0.01).After 2 weeks of treatment,CMT decreased in both groups,The treatment group was improved compared with that before treatment(P<0.01),there was no statistically significant difference between the control group and before treatment(P>0.05),the treatment group was better than the control group(P<0.05).After 1 month and 3 months of treatment,CMT of the two groups decreased compared with that before treatment(P<0.05 or P<0.01),the decrease range of the treatment group was greater than that of the control group(P<0.05 or P<0.01).After 2 weeks,1 month and 3 months of treatment,the CMV of both groups decreased compared with before treatment(P<0.01

关 键 词：视网膜分支静脉阻塞 黄斑水肿 活血明目汤 雷珠单抗 

分 类 号：R772.2[医药卫生—眼科]